Bradley D J
Department of Epidemiology & Population Sciences, London School of Hygiene and Tropical Medicine, UK.
Ciba Found Symp. 1993;175:234-44; discussion 244-6.
Environmental variables largely determine the disease pattern in developing countries. Infections and malnutrition predominate, due to the effects of both poverty (a summary of many aspects of material deprivation) and a high ambient temperature. Environmental changes may be intended to improve health--examples include improved domestic water supplies and sanitation--or they may be due to socio-economic developments, which often have favourable or unfavourable health consequences. These are explored for water resource developments, where the health effects are complex, and for deforestation and urbanization. Although environmental impact assessment has been of value in reducing the adverse health impacts of socio-economic development projects, the use of health opportunity assessment is proposed as a more positive approach to optimizing the consequences of development to human health.
环境变量在很大程度上决定了发展中国家的疾病模式。由于贫困（物质匮乏诸多方面的一种概括）和高温环境的影响，感染和营养不良占主导地位。环境变化可能旨在改善健康状况——例如改善家庭供水和卫生条件——或者可能是由于社会经济发展，而社会经济发展往往会产生有利或不利的健康后果。本文探讨了水资源开发（其对健康的影响很复杂）、森林砍伐和城市化等方面的情况。尽管环境影响评估在减少社会经济发展项目对健康的不利影响方面具有价值，但建议采用健康机会评估作为一种更积极的方法，以优化发展对人类健康的影响。
